Persistent fetal circulation: An evolving clinical and radiographic concept of pulmonary hypertension of the newborn

The roentgenographic presentations of 11 newborn infants with hypoxemia secondary to pulmonary vasospasm and subsequent right-to-left shunting of blood through the foramen ovale and/or ductus arteriosus (persistent fetal circulation) are described (P. F. C. Syndrome). One infant had radiographically normal lungs, while ten had pulmonary parenchymal abnormalities including hyaline membrane disease 4], meconium aspiration syndrome 4], or an ill defined pattern of retained lung fluid 2]. The roentgenographic appearance of the lungs, however, was discordant with the severe hypoxemia observed in most. Heart size was variable but some degree of cardiomegaly was commonly present. Tolazoline, a potent vasodilator, was useful diagnostically and may have resulted in increased survival. An expanded clinical and roentgenographic concept of the PFC syndrome is suggested.Presented in part at The Annual Meeting of the Society for Pediatric Radiology, Atlanta, Georgia, September, 1975, and at the 13th Meeting of the European Society of Pediatric Radiology, Stockholm, Sweden, May 21, 1976